Jack Cletcher, a retired orthopedic surgeon, is an avid hunter in Longmont, Colo. He opposes most of the new gun restrictions lawmakers are discussing.

Barry Gutierrez
/ for NPR

Listen

Listening...

/

Originally published on March 22, 2013 2:29 pm

In Colorado, more people die from gunshots than car crashes. And that has a profound effect on the people on the front lines who treat gunshot victims.

Chris Colwell is an emergency room doctor in Denver, and says he sees gun violence victims on a weekly basis. When those cases are fatal, they are hard for him to forget.

"They'll come in, and they'll look at me, and they'll talk to me, and then they'll die," says Colwell, who has been at Denver Health, the city's biggest public hospital, for 20 years.

Colwell also treated casualties from two of the deadliest mass shootings in American history. He responded to the scene during the 1999 massacre at Columbine High School, where 15 died. He also treated victims of last July's movie theater shooting in Aurora, where a dozen were killed and 58 were wounded.

But he doesn't just treat the victims — often, he'll also treat the shooter after he or she has been caught by police. Colwell describes a case from a few months ago where he treated a woman — who later died — and her husband, the shooter.

"They had had a fight. He had caught her in what he felt was cheating, and he had lost his temper," he says. "He went and grabbed the pistol that he had for home defense at his bedside, and he made a snap decision, and he realized his life will never be the same, and hers was gone."

He says it's remarkable how often people who pull the trigger are surprised at the consequences of their actions. And he's deeply disturbed by how easy it is to get guns.

"I see patients every day that are right on the edge of being unstable and are out there in the environment, and they describe problems with access to medications, problems with access to psychiatric care or substance abuse care, problems with access to homes or to shelter," says Colwell. "But they don't describe problems with access to guns."

Dr. Katie Bakes has worked with Colwell in the emergency department for 10 years. She says she can't shake the gunshot victims, either.

A few weeks ago, she came to work and learned that an ambulance was rushing in with a 3-year-old who'd been shot in the head. The mother had shot each of her three children and then committed suicide.

"Our patient was the only one who was a survivor," Bakes says.

Bakes is unequivocal in her opposition to guns:

"I hate guns. If I could snap my finger and get rid of all the guns, I would. I think they're evil. ... People are making money off them, and people are dying. And at some point, when we see what we see, I don't really care what the other side of the argument is. I don't care. I just don't want to see another 3-year-old come in and be shot in the head."

Bakes and Colwell say gun injuries seem much more deliberate than any other kind of trauma they see.

Dr. Jack Cletcher is a retired orthopedic surgeon and avid hunter in Longmont, Colo. He's treated his share of gunshot victims, too. Decades ago, he took care of wounded soldiers just off the plane from Vietnam.

He can sympathize with Bakes and Colwell, but he doesn't see guns as the root of the problem.

"This is the kind of emotional reaction that occurs with these horrible catastrophes that happen," Cletcher says. "The gun is only the instrument. It's not something that happens because the gun does it. There has to be somebody holding the gun to do it."

Cletcher is opposed to most of the new gun restrictions lawmakers are talking about in Denver and Washington, D.C.

"I don't think we need new laws; we just need to make the ones we have work better," says Cletcher. He would rather see lawmakers focus on better treatment for the mentally ill, and keeping guns out of their hands, he says.

Recently, leaders of the Colorado chapter of the American Medical Association went to Washington to lobby for measures to help prevent gun violence. Strengthening mental health care was on their agenda, and they support President Obama's executive action for increased research into gun violence.

Dr. John Bender, president-elect of the chapter, showed Rep. Ed Perlmutter, D-Colo., the results of a recent survey of Colorado AMA members, showing about two-thirds of their membership want to see gun regulations strengthened, and about a third don't. (There are other doctors around the country who don't, either.)

But a majority of AMA delegates at the national level have endorsed tighter restrictions on guns.

We head back to Colorado now for our series on Guns in America. The state has had two of the nation's deadliest mass shootings, the 1999 massacre at Columbine High School, where 15 died, and last July's movie theatre shooting at Aurora, which killed 12 people. Colorado is also one of a dozen states where federal numbers show more people died from guns than auto accidents in 2010.

Doctors are in a unique position when it comes to gun violence. They may respond to a shooting scene or see victims in an emergency room.

Colorado Public Radio's Eric Whitney reports talked to doctors about how those experiences affect their views on guns.

ERIC WHITNEY, BYLINE: The emergency room at Denver Health is a busy place. It's the city's biggest public hospital and it sees all kinds of carnage. Dr. Chris Colwell has worked here for 20 years. He says the patients who stick in his mind are the gunshot victims.

DR. CHRIS COLWELL: The reason that so many of the gunshot victims stick with me is because these are the injuries that they'll come in and they'll be look at me, and they'll talk to me and then they'll die.

WHITNEY: Colwell knows trauma. He responded to the Columbine school shooting, treated victims from the Aurora movie theatre and, depending on the week, he could see one, two or more gunshot wounds in the ER.

COLWELL: I don't want to overstate that, you know, we're dealing with shootings every hour of every day but I think anybody would be surprised at how common it is to see victims of gunshot wounds in the emergency departments, here in Denver and across the country.

WHITNEY: Often, Colwell will treat the victim or victims of a shooting and then, a short time later, treat the shooter after he or she has been caught by police. He says this happened a few months ago.

COLWELL: This was in December, where we had a husband who had shot his wife and killed her. And we had seen her about an hour before. And they brought him in after they had apprehended him. And you could just see the absolute devastation on his face.

WHITNEY: Colwell says it's remarkable how often people who pull the trigger are surprised at the consequences of their actions.

COLWELL: They'd had a fight. He had caught her in what he felt was cheating and he had lost his temper and he went and grabbed a pistol that he had for home defense at his bedside and he made a snap decision. And he realized that that decision now will never - his life will never be the same and hers was gone. And she was dead.

WHITNEY: Colwell says he's no policy maker but he finds it disturbing how easy guns are to get.

COLWELL: I see patients every day that are right on the edge of being unstable and are out there in the environment and they describe problems with access to medications, problems with access to psychiatric care, or substance abuse care, problems with access to homes or to shelter. But they don't describe problems with access to guns.

WHITNEY: Dr. Katy Bakes has worked with Colwell in the ER for 10 years. She, too, says it's the gunshot victims that she can't shake. A few weeks ago, she came to work and learned that an ambulance was rushing in with a three-year-old who'd been shot in the head.

DR. KATY BAKES: The mom killed herself and shot her three children, two of which were dead when the paramedics were there. And our patient was the only one who was a survivor.

WHITNEY: Kids who've been shot, Bakes says, are the worst.

BAKES: I hate guns. If I could snap my finger and get rid of all the guns, I would. I think they're evil. I think people are making money off them and people are dying. And at some point, when we see what we see, I don't really care what the other side of the argument is. I don't care. I just don't want to see another three-year-old come in and be shot in the head. I don't care what your argument is, it's not going to trump that.

WHITNEY: Bakes says treating gunshot victims takes an emotional toll on the team in the ER, because she feels gun injuries are much more deliberate than any other kind of trauma they see.

BAKES: It's so senseless. You know, it's not an accident. It's something that was - somebody intentionally pulled the trigger for whatever reason.

DR. JACK CLETCHER: This is the kind of emotional reaction that occurs with these horrible catastrophes that happen.

WHITNEY: Dr. Jack Cletcher is a retired orthopedic surgeon. He's treated his share of gunshot victims, too, from the streets of Chicago and wounded soldiers just off the plane from Vietnam.

CLETCHER: The gun is only the instrument. It's not something that happens because the gun does it. There has to be somebody holding the gun to do it.

WHITNEY: Cletcher is opposed to most of the new gun restrictions lawmakers are talking about in Denver and Washington.

CLETCHER: I don't think we need new laws, we just to make the ones we have work better.

WHITNEY: Cletcher says that rather than restricting assault weapons or the number of bullets a gun can carry, lawmakers should focus on better treatment for the mentally ill and keeping guns out of their hands.

UNIDENTIFIED WOMAN: Welcome.

WHITNEY: Recently, leaders of the Colorado chapter of the American Medical Association went to Washington. They met with members of Congress, including Democratic Representative Ed Perlmutter.

REPRESENTATIVE ED PERLMUTTER: You know, these things really take its toll on people and on a community. And I appreciate the effort that you all are taking, you know, 'cause you're stepping out on this.

WHITNEY: Dr. John Bender showed him the results of a recent survey of Colorado AMA members.

DR. JOHN BENDER: About 65 percent of our membership would like to see gun regulation strengthened. About 34 percent want to see it left where it's at or actually pulled back. So about a two-thirds/one-third split.

WHITNEY: No similar survey exists for doctors nationwide but a majority of AMA delegates have endorsed tighter restrictions on guns. The AMA and several other physicians' groups sent letters to Vice President Joe Biden's working group on gun violence. All of them are urging a ban on assault weapons and high capacity ammunition magazines.

For NPR News, I'm Eric Whitney in Denver.

SIEGEL: That story is part of a partnership between NPR, Colorado Public Radio and Kaiser Health News. Transcript provided by NPR, Copyright NPR.